Individual provider Active NPI

Charles Andrew Heiskell, MD

  • Surgery Physician
  • Morgantown, WV
National Provider Identifier
1154308286
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
10455 Issued in WV
Practice address
600 Suncrest Towne Centre
Suite 310
Morgantown, WV 26505-1872
Phone
(304) 598-2200
Fax
(304) 599-2674
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 10455 WV Primary

Addresses

Primary practice location

600 Suncrest Towne Centre
Suite 310
Morgantown, WV 26505-1872

Mailing address

600 Suncrest Towne Centre
Suite 310
Morgantown, WV 26505-1872
Phone (304) 598-2200

Other identifiers 1

IdentifierTypeStateIssuer
0127483000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100506000685 WV Practitioner - General Surgery 4981653987 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10455WVMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Monongalia County General Hospital Company CurrentSince Jul 1, 2014 Accepting new patients
Preston Memorial Hospital Corporation CurrentSince Apr 27, 2024 Accepting new patients
Preston Memorial Hospital Corporation Surgery CurrentSince Apr 27, 2024 Accepting new patients

Locations

150 Memorial Dr
Kingwood, WV 26537
Phone (304) 329-4701

600 Suncrest Town Centre Dr
Ste 310
Morgantown, WV 26505
Phone (304) 598-2200

1200 J D Anderson Dr
Morgantown, WV 26505
Phone (304) 598-1460

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/preston-adacdb24

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1154308286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SUNCREST TOWNE CENTRE",
            "address_2": "SUITE 310",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265051872",
            "telephone_number": "304-598-2200",
            "fax_number": "304-599-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SUNCREST TOWNE CENTRE",
            "address_2": "SUITE 310",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265051872",
            "telephone_number": "304-598-2200",
            "fax_number": "304-599-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISKELL",
        "first_name": "CHARLES",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "10455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0127483000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.